The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Volume 34 , Issue 6
Showing 1-50 articles out of 95 articles from the selected issue
  • Type: Cover
    2012 Volume 34 Issue 6 Pages Cover1-
    Published: November 25, 2012
    Released: October 29, 2016
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  • Type: Appendix
    2012 Volume 34 Issue 6 Pages App1-
    Published: November 25, 2012
    Released: October 29, 2016
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  • Type: Appendix
    2012 Volume 34 Issue 6 Pages App2-
    Published: November 25, 2012
    Released: October 29, 2016
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  • Type: Appendix
    2012 Volume 34 Issue 6 Pages App3-
    Published: November 25, 2012
    Released: October 29, 2016
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  • Type: Index
    2012 Volume 34 Issue 6 Pages Toc1-
    Published: November 25, 2012
    Released: October 29, 2016
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  • Type: Index
    2012 Volume 34 Issue 6 Pages Toc2-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 539-540
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 541-542
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 543-544
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 545-546
    Published: November 25, 2012
    Released: October 29, 2016
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  • Manabu Hayama, Hiroyuki Tanaka, Misato Okamura, Osamu Kanai, Tomotaka ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 547-551
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Diffuse alveolar hemorrhage (DAH) is a severe condition and is often difficult to diagnose and treat. Purpose. We retrospectively reviewed records of patients with DAH and evaluated the clinical features. Methods. We investigated 11 cases of DAH hospitalized at Kyoto Medical Center in Japan from April 2006 to April 2011. These cases were diagnosed by bronchoalveolar lavage (BAL) and on the basis of their clinical manifestations. Results. Of the 11 patients investigated in this study, 7 were men and 4 were women. The mean age was 69.5 year. Hemoptysis was absent in 4 patients. Eight patients had respiratory failure and 7 underwent mechanical ventilation. The etiologies included microscopic polyangiitis (MPA) in 5 patients, systemic lupus erythematosus (SLE) in 1, and aplastic anemia in 1. The etiologies in the other patients were unknown. In all cases, chest computed tomography (CT) revealed increased intensity in multiple lobe. Lung biopsy was not performed because of serious respiratory failure and the risk of bleeding. All patients received steroid therapy, and a higher steroid dose was administered to 9 patients. Of the 11 patients in the study, 9 survived and 2 died (mortality rate: 18%). Conclusion. The underlying causes of DAH are varied, but MPA was the most frequent etiology observed in this study. BAL was useful in diagnosis because hemoptysis, a typical symptom, was absent in some cases. In many cases, DAH is caused by vasculitis and collagen vascular disease that is responsive to steroid therapy. Hence, it is very important to use BAL for the diagnosis of DAH.
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  • Kazuyoshi Nakamura, Hidenori Ichiyasu, Kentaro Tokunaga, Yuko Horio, H ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 552-557
    Published: November 25, 2012
    Released: October 29, 2016
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    Cases. Case 1: A 69-year-old man was referred to our hospital with left pleural effusion. Eosinophilia in peripheral blood and pleural effusion were identified. The effusion was exudative with low pH, low glucose and high lactate dehydrogenase (LDH) levels. Case 2: A 69-year-old man was admitted to our hospital with abdominal pain. Chest CT showed a mass shadow in the right upper lobe and right pleural effusion. He had eosinophilia, but the eosinophil fraction of his pleural effusion was 7%. The effusion was exudative with low pH, low glucose and high LDH levels. Analysis of a transbronchial lung biopsy specimen of the mass lesion revealed prominent eosinophilic infiltration. In both the cases, they had histories of eating raw boar meat, and Paragonimus westermani-specific IgG antibody titers were extremely high in their serum. Thus, P. westermani infection was diagnosed. After oral administration of praziquantel, their chest CT and eosinophilia were improved. Conclusion. P. westermani is a parasite of freshwater crabs, and consumption of inadequately cooked crabs causes infection with this parasite. Wild boars are paratenic hosts of P. westermani and the infection in humans is also caused by eating raw or improperly cooked boar meat. Pulmonary infiltration with eosinophilia in the peripheral blood and pleural effusion, abdominal pain, and history of eating raw boar meat suggest P. westermani infection.
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  • Satomu Morita, Takayuki Takimoto, Yujiro Naito, Akio Osa, Haruko Terad ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 558-563
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Bofu-tsusho-san is a herbal medicine sold as an over-the-counter medicine in Japan for losing weight. We report a case of severe drug-induced pneumonitis which was caused by it. Case. A 66-year-old woman was admitted to our hospital with dyspnea and fever. Three weeks before admission, she had started to take an over-the-counter herbal medicine, bofu-tsusho-san. Chest CT showed diffuse ground glass attenuation in both lung fields. Thereafter, her respiratory condition deteriorated progressively and mechanical ventilation was needed. Bronchoalveolar lavage fluid showed a high percentage of eosinophils and lymphocytes. Drug-induced pneumonitis caused by bofu-tsusho-san was diagnosed, and was treated successfully with steroid therapy. The results of drug lymphocyte stimulation test for bofu-tsusho-san were positive. Conclusion. Clinicians should recognize the potential of drug-induced pneumonitis caused by over-the-counter herbal medicine.
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  • Hiroaki Oka, Hiroshi Ishii, Atsushi Yokoyama, Hisako Kushima, Hiroki Y ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 564-567
    Published: November 25, 2012
    Released: October 29, 2016
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    Case. A 55-year-old asymptomatic woman had been found to have infiltrates on a chest X-ray film on a routine checkup examination. Six months later, she visited our hospital because of increase of the chest shadows. A chest computed tomography revealed multiple infiltrates bilaterally. Laboratory findings on admission showed elevated hepatobiliary enzymes, positive for anti-centromere antibody, but negative for anti-mitochondrial antibodies in her serum. No distinct findings of autoimmune disease were found clinically. In histological examinations, a surgical lung biopsy specimen demonstrated an organizing pneumonia pattern, and a liver biopsy specimen showed findings of nonspecific chronic hepatitis. The chest image findings and the elevated hepatobiliary enzymes improved in response to the treatment with corticosteroid. Conclusion. To the best of our knowledge, this is a rare case of organizing pneumonia associated with unclassified autoimmune liver disease.
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  • Tomoyuki Ogata, Kimitake Tsuchiya, Shiro Sonoda, Shuta Yamauchi, Masah ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 568-572
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Temsirolimus, a selective inhibitor of mammalian target of rapamycin (mTOR), is one of the few effective drugs for patients with advanced renal cell carcinoma, but might induce interstitial pneumonia. Case. A 52-year-old man who had been treated with temsirolimus for advanced renal cell carcinoma complained of dyspnea on exertion 44 days after initiation of the temsirolimus treatment and was diagnosed as having interstitial pneumonia. Chest CT scan showed diffuse non-segmental consolidation bilaterally mainly in the lower lobes. Transbronchial lung biopsy revealed diffuse alveolar damage (DAD). The treatment with corticosteroid was effective. However, the fibrotic change of the lung remained and he needed oxygen therapy even after the corticosteroid treatment. Conclusion. Although reported cases of temsirolimus induced interstitial pneumonia are rare in Japan, we should be careful of its occurrence with possible increased use of this drug in the future.
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  • Tomohito Tarukawa, Katsutoshi Adachi, Yoichi Nishii, Hajime Fujimoto, ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 573-576
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. The surgical treatment of chronic empyema with bronchopleural fistula is often difficult because of poor general condition, advanced age and so on. It has been reported that bronchial occlusion with an endobronchial Watanabe spigot (EWS) can be effective treatment. Case. An 87-year-old man underwent thoracoplasty for chronic empyema with bronchopleural fistula at age 85. However, since empyema with bronchopleural fistula recurred, we performed bronchial embolization with EWS under general anesthesia. The air leakage stopped immediately and he was discharged. Conclusion. This report suggests that the bronchial embolization using EWS could be considered as an effective treatment option for empyema with intractable bronchopleural fistula.
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  • Naoya Kawakita, Takanori Miyoshi, Hisashi Matsuoka, Masaru Tsuyuguchi
    Type: Article
    2012 Volume 34 Issue 6 Pages 577-581
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Primary tracheal schwannoma originating in the trachea is a rare tumor. Here, we report a case of primary tracheal schwannoma resected using bronchoscopy and high-frequency jet ventilation (HFJV). Case. A 36-year-old man was admitted to our hospital with sudden dyspnea. A chest computed tomography examination showed left pneumothorax, pneumomediastinum, and a lower tracheal intraluminal tumor about 3cm in diameter. Thoracic drainage was performed, and a subsequent bronchoscopic examination showed an intraluminal polypoid tumor obstructing the right main bronchus. The tumor had a glossy and patterned indented surface. No tracheal or bronchial injury was proven, and the pneumothorax improved immediately. Nine days after the first visit, bronchoscopic resection was performed using a high-frequency electrosurgical snare under general anesthesia combined with HFJV. Pathological examination revealed a primary tracheal Antoni A-type schwannoma. After resection, bronchoscopic examinations and biopsies with submucosal injection were performed twice. The second examination showed no residual tumor. Conclusion. In the present case, bronchoscopic high-frequency electrosurgical snare resection using HFJV was useful in treating a large primary tracheal schwannoma.
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  • Junya Nakaya, Keiichiro Takase, Toru Kojima, Wataru Yamaguchi, Toshika ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 582-587
    Published: November 25, 2012
    Released: October 29, 2016
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    Case. A 55-year-old woman undergoing treatment for chronic kidney disease was hospitalized in September 2008 because of worsening productive cough and fever. Chest computed tomography revealed patchy pulmonary shadows and cavitary consolidations. A definitive diagnosis of pulmonary mucormycosis was made on the basis of bronchoscopic transbronchial lung biopsy. Biopsy specimens showed broad non-septate hyphae with right-angled branching, a specific finding of mucormycosis. Liposomal amphotericin B was administered until late November 2008, which ameliorated her symptoms and reduced the pulmonary shadows. However, there was relapse of pulmonary mucormycosis in early January 2009, accompanied by low-grade fever, fatigue and new pulmonary infiltrates. Despite restarting liposomal amphotericin B, her chest X-ray findings progressively worsened. We assumed that metabolic acidosis and decreased cellular immunity due to chronic kidney disease were associated with resistance to antifungal treatment. Early hemodialysis was initiated, although her serum creatine level was 4.8mg/dl. Subsequently, her symptoms and pulmonary infiltrates resolved completely. Conclusion. We considered that early hemodialysis contributed to the inhibition of fungal proliferation by improving her cellular immunity and metabolic acidosis.
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  • Keiji Mouri, Yoshihiro Kobashi, Masaki Ikeda, Yoshihiro Ohue, Yasushi ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 588-593
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Although there are a few case reports of solitary pulmonary nodule due to Mycobacterium kansasii, there are no case reports with mediastinal lymphadenopathy. We reported an unusual case due to M. kansasii in which bronchoscopic procedures, including endobronchial ultrasound-guided transbronchial needle aspiration fluid (EBUS-TBNAF), were useful to obtain the diagnosis. Case. A 53-year-old man visited our hospital with fever. There was no past history of respiratory underlying diseases or immunosuppressed conditions. Chest CT showed a nodular shadow in the right upper lobe and mediastinal lymphadenopathy. We confirmed a final diagnosis of nontuberculous mycobacterial disease due to M. kansasii from the bronchoalveolar lavage fluid (BALF) for the nodular lesion and EBUS-TBNA for the mediastinal lymphadenopathy. Afterwards, the clinical symptoms, inflammatory responses and abnormal chest shadows improved in response to combined therapy with antituberculous drugs. Conclusion. Although this is a very rare case of not only a nodular shadow but also mediastinal lymphadenopathy due to M. kansasii slightly increased, bronchoscopic procedures including EBUS-TBNAF were useful to establish the diagnosis.
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  • Tsutomu Marui, Hideko Goto, Takaaki Hasegawa, Youhei Futamura, Akane H ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 594-598
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Middle mediastinal malignant lymphomas with cystic shadows are very rare. Case. A 37-year-old man visited our hospital with pyrexia and chest pain. Enhanced chest CT revealed a cystic lesion in the left thyroid lobe and a homogeneous middle mediastinal tumor measuring 5.3×3.8×5.1cm, but with cystic shadows. Positron emission tomography (PET) showed accumulation in the homogeneous part of the tumor. Video-assisted thoracic surgery (VATS) was performed to establish a diagnosis. Histological, immunological, surface marker and genetic examination of the excised tumor revealed a T-cell lymphoblastic lymphoma for which adjuvant chemotherapy was performed. Conclusion. We report a rare case of malignant lymphoma with cystic shadows in the middle mediastinum.
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  • Fumi Karino, Shinichi Iwamoto, Akihisa Sutani, Takashige Kuraki, Takes ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 599-603
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Airway constriction caused by granulomatous lesions after tracheotomy is one of the serious causes of central airway stenosis. We report a case of a granuloma in which size reduction was successfully achieved by systemic administration of steroids, and we were thereafter able to safely perform snare ablation. Case. The case involved a man in his 60's. Tracheotomy had been performed during surgery for tongue cancer, and the trachea tube had been removed on postoperative day 13. He began to experience airway obstruction during exhalation around three months after surgery. Due to the fact that dyspnea symptoms began to gradually worsen in the supine and left lateral decubitus position, he was hospitalized for further examination. The contrast CT findings showed tracheal stenosis due to pedunculated granulation measuring 9×15mm in size. Bronchoscopy demonstrated a movable mass in the trachea which had markedly narrowed the tracheal lumen. Because he could not remain in a supine position for long periods of time, and the risk of suffocation was high, immediate intervention was thus considered to be impossible. After the systemic administration of steroids was performed, the granulomatous lesions were observed to have significantly decreased in size and he felt an improved sense of airway flow. Ablation was thereafter performed under general anesthesia and we were able to maintain the airway perfectly using a rigid scope snare. Conclusion. We herein report the findings of a case presenting with pedunculated granuloma after tracheostomy which a reduction in the size of the granuloma was successfully achieved using a sufficient amount of systemic steroids before snare ablation could be safely performed.
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  • Shinichi Iwamoto, Hibiki Kanda, Akihisa Sutani, Takashige Kuraki, Take ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 604-610
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Metastatic bronchial tumors from colon cancer generally have a poor prognosis. Case. The patient was a 44-year-old woman who presented with hemoptysis, wheezing, and dyspnea and was admitted 6 years after resection of sigmoid colon cancer. Whole-body CT detected many tumors in the trachea and bronchi we diagnosed metastatic bronchial tumors from colon cancer. Laryngeal arterial embolization was performed on the day before surgical endoscopy to reduce the risk of bleeding and the tumor volume. An extracorporeal membrane oxygenation was used because of the high risk associated with tracheal stenosis. Airway management was carried out with a laryngeal mask, and multiple protruding lesions were excised by electrosurgical snaring. The symptoms of airway stenosis disappeared after extubation. Radiation and chemotherapy were administered and the tracheal tumors showed complete response. Conclusion. This report describes a rare case of airway stenosis due to multiple metastatic bronchial tumors that developed 6 years after resection of colon cancer. Surgical endoscopy sufficiently improved the airway stenosis and overall condition to allow the administration of additional treatment.
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  • Yosuke Shimizu, Yoshitaka Ito, Keiichiro Takase, Toru Kojima, Junya Na ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 611-615
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. The benign metastasizing leiomyoma is the rare clinical condition that a benign uterine leiomyoma causes metastasis to the other organ. Case. A 37-year-old woman underwent hysteromyomectomy at the time of childbirth by cesarean section 4 years ago. She had a history of hospitalization due to pneumonia of the right lower lobe. This time, she consulted our hospital with chief complaints of cough and fever. A careful examination was performed, and obstructive pneumonia due to a mass of 6mm in diameter which almost occluded right B^<10>_b was diagnosed. The mass was diagnosed as leiomyoma by biopsy. Because obstructive pneumonia was recurrent, and inflammation spread to the adjacent segment, right basal segmentectomy was performed after inflammation calmed down by antibiotics. Histopathologically, the mass consisted of the similarity with poorly acidophilic atypical fusiform cells. In consideration of the pathologic findings of the previous uterine myoma and results of the immunostaining, it was diagnosed as metastasis to the bronchus of the benign uterine leiomyoma. Conclusion. We report a case of benign metastasizing leiomyoma of the bronchus, which has not previously been reported.
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  • Shuta Yamauchi, Meiyo Tamaoka, Tsukasa Okamoto, Tomoyuki Ogata, Kimita ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 616-620
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can be performed as a minimally invasive procedure to diagnose mediastinal lesions. Case. A 48-year-old man with a history of chemotherapy for malignant lymphoma underwent follow-up chest computed tomography (CT), which showed a round, well-circumscribed 29×23mm mass in the right superior mediastinum. ^<18>F-fluorodeoxyglucose positron emission tomography/CT (^<18>F-FDG-PET/CT) demonstrated mild radiotracer uptake in the mass lesion with maximum standardized uptake value (SUVmax) of 2.8. To differentiate recurrence of malignant lymphoma from other mediastinal tumors, EBUS-TBNA was performed. The histological diagnosis was mediastinal schwannoma, which seemed to have originated from the intrathoracic vagus nerve. Surgical resection was avoided in order to prevent recurrent nerve paralysis as a complication of surgery. The tumor has not increased in size during a 2.5-year period. Conclusion. Almost all reported cases of mediastinal schwannomas were diagnosed by surgical resection. In the present case, we could diagnose the mediastinal schwannoma by minimally invasive EBUS-TBNA and avoid potential complications of surgery. EBUS-TBNA can be applied to patients as a preoperative diagnostic procedure for all accessible mediastinal lesions contiguous with the trachea or bronchi.
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  • Takayuki Shiroyama, Norio Okamoto, Hidekazu Suzuki, Motohiro Tamiya, K ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 621-625
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. The diagnosis of prostate cancer because of respiratory symptoms is rare. Here, we report a case of prostate cancer that was diagnosed on detection of metastases to the hilar and mediastinal lymph nodes by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) using immunohistochemistry. Case. A 68-year-old man with cough, dyspnea, and an abnormal chest shadow on radiography was referred to our hospital. No urinary symptoms were observed. His chest computed tomography showed multiple lung nodules and enlarged hilar and mediastinal lymph nodes. 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) showed abnormal uptake in those lesions and in the right lobe of the prostate. We performed EBUS-TBNA of the enlarged hilar and mediastinal lymph nodes by using immunohistochemistry, and hilar and mediastinal lymph nodes metastases of prostate cancer was diagnosed pathologically. Prostate biopsy was performed by an urologist, and thereafter, hormone therapy was begun. Conclusion. We report a case of prostate cancer diagnosed because of a respiratory symptom detected by EBUS-TBNA. FDG-PET views should be taken into account before deciding the site of biopsy specimen collection.
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  • Ken Takeuchi, Yoshiaki Inoue, Masatoshi Gika, Keisuke Eguchi, Mitsuo N ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 626-630
    Published: November 25, 2012
    Released: October 29, 2016
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    Background. Tracheal cancers are rare malignancies, and generally found due to respiratory symptoms caused by an enlarged mass in the tracheal lumen. Case. A 72-year-old man suffering from wheezing had been treated for bronchial asthma for 12 months. However, bleeding was detected in airway during general anesthesia performed due to another disease. Bronchoscopy showed primary tracheal cancer during the operations and he was referred to our hospital. The tumor extended from the lower trachea to left main bronchus. Since the tumor was unresectable, multidisciplinary treatment was performed. The tumor became smaller and the endobronchial lesion also decreased. The effect was complete response. After 3 years and 6 months of follow-up, the patient was asymptomatic. Conclusion. A diagnosis of primary tracheal cancer is often overlooked, leading to some delay in definitive diagnosis because the symptoms are not specific. It can cause life-threatening airway obstruction and thus should be considered in the differential diagnosis of patients with bronchial asthma.
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  • [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 631-632
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 633-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 633-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 633-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (237K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 633-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (237K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Type: Article
    2012 Volume 34 Issue 6 Pages 633-634
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 634-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 634-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (211K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 634-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (211K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 634-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 635-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 635-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 635-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 635-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 635-636
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 636-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 636-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (260K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 636-
    Published: November 25, 2012
    Released: October 29, 2016
    JOURNALS FREE ACCESS
    Download PDF (260K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 636-
    Published: November 25, 2012
    Released: October 29, 2016
    JOURNALS FREE ACCESS
    Download PDF (260K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 636-637
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 637-
    Published: November 25, 2012
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 637-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (266K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 637-
    Published: November 25, 2012
    Released: October 29, 2016
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    Download PDF (266K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2012 Volume 34 Issue 6 Pages 637-
    Published: November 25, 2012
    Released: October 29, 2016
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